Nearly 140 million girls and women worldwide have undergone female genital mutilation. But experts say there is reason to believe the practice is waning in many of the 29 countries where it is most widespread.

In many parts of the Kween District of eastern Uganda, women are divided into two distinct categories.

“There are the uncircumcised and the circumcised,” says Beatrice Chepet, who lives in the area.

That divisionis not merely physical, but has social and economic consequences as well.

Circumcised women – those who have undergone a process known within the international human rights community as female genital mutilation, or FGM – are allowed to collect corn for their families from the local granary. Uncircumcised women are not. Circumcised women can milk cows. Uncircumcised women cannot.

So when Ms. Chepet was 16 she made a choice: she would be circumcised by her clan’s female elders.

“It hurt. Even [later] during labor time I was suffering a lot,” says Chepet, who has given birth to nine children since the procedure. But there were benefits as well – for instance, the community no longer harbored superstitions that her husband would die because he was married to an uncircumcised woman.

Chepet is one of some 140 million girls and women worldwide who have undergone FGM, an umbrella term for several practices that remove or alter portions of the female genitalia for non-medical reasons, according to statistics gathered by the World Health Organization.

The practice has deep roots across large swaths of Africa and the Middle East, where it is millenniums old, but traditions are not unmoving – and neither are views on FGM. And as governments and NGOs mark the 11th annual Day of Zero Tolerance for Female Genital Mutilation today, experts say there is reason to believe the practice is waning in many of the 29 countries where it is widespread. This is in large part due to the demands of those living in communities that practice it.

In those countries, an average of 36 percent of girls ages 15-19 have been cut, compared to 53 percent of women 45-49, according to figures released today by the United Nations Population Fund (UNFPA) and the UN Children’s Fund (UNICEF). Although there remain stubborn outliers to the trend, like Somalia and Guinea, where more than 90 percent of women have been cut in every age group, the overall prevalence of FGM has dipped in several countries since the early 2000s, when the UN and other international agencies first launched a comprehensive campaign against the practice.

The movement has gained global traction as well: in December the UN General Assembly unanimously passed a resolution condemning the practice, calling it "irreparable, irreversible abuse” to girls and women.

“In the last couple of years, this issue has really taken off in the international space,” says Gannon Gillespie, director of strategic development for Tostan, an NGO in West Africa that works on FGM issues. “One reason is because it’s a [human rights] area where we can really see progress – and people are looking for that.”

Grassroots work

Efforts to end FGM have long been complicated by colonialism and its aftereffects, which left many Middle Eastern and African societies sensitive to interference in their cultural affairs. But experts say that FGM eradication has been successful in building momentum as a global human rights campaign precisely because it is rarely driven by outsiders.

“The vast majority of people working on this issue on the ground are people from the country [where FGM is practiced],” says Cody Donahue, a child protection specialist for UNICEF. “The UN comes in because we’re invited by governments to work on the issue.”

The most successful efforts have been led by local governments or NGOs with the support of community and religious leaders, Mr. Donahue says. These programs tend to be tethered to other women’s rights causes, such as access to health and education and gender-based equality laws.

Fighting FGM in tandem with other human rights issues tends to be far more effective than simply condemning communities that practice it, says Donahue.

In Uganda, for example, a bill that took effect in March 2010 makes it a criminal offense to carry out FGM, as well as participate in any event leading to its practice or the discrimination against a female who hasn’t undergone the procedure. Dozens of arrests have been made since the law's introduction – including at least seven for self-inflicted FGM – but almost none have been successfully prosecuted. The majority were dismissed for "want of prosecution," according to the Reproductive, Educative and Community Health (REACH) program, a group launched by the UN in Uganda in 1996.

Big hurdles: income, stigmas

What's more, in rural districts of Uganda where the practice is commonplace, it comes knotted to cultural and economic norms that cannot be done away with by legislation alone. Women who perform the procedure, for instance, earn up to 80,000 Ugandan shillings ($30) per girl in a country with an average yearly income of about $300.

“You can see why it would be difficult to ask them to leave the only income generating activity they know,” says Onyema Afulukwe, a legal adviser on Africa at the Center for Reproductive Rights in New York. “Despite the laws, the government hasn’t made nearly enough effort to sensitize and raise awareness about why this practice must end.”

And without educational programs, she says, communities will continue to practice FGM because the social stigma of not doing so asserts a stronger pull than the force of the law.

The most successful anti-FGM campaigns have bound together legislation – now on the books in more than a dozen African countries – with community-led programming to reduce the stigma of not undergoing FGM. The logic, says Donahue, of UNICEF, is that while FGM may seem like an incredibly intimate and individual act, it is an intricate part of the social structure of many communities. So the entire community must "buy in" to efforts to end the practice.

“People are participating in this practice out of love for the most part,” Mr. Gillespie says. “There aren’t evil intentions here – and once you understand that you see the pathway to how it might change.”

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